Factors affecting burnout in physicians during COVID-19 pandemic
Year 2021,
Volume: 60 Issue: 2, 136 - 144, 30.06.2021
Osman Hasan Tahsin Kılıç
,
Murat Anıl
Umut Varol
Zeynep Sofuoğlu
,
Istemihan Coban
,
Hakan Gülmez
,
Güven Güvendi
,
Berna Dirim Mete
Abstract
Aim: The COVID-19 outbreak continues to pose a threat to people's physical and mental health all over the world. The health professionals who are directly involved in the fight against the pandemic may experience stress during this crisis that can cause Burnout and Secondary traumatic stress. The objective of our study was to assess the burnout among physicians during COVID-19 pandemic and to determine related factors.
Materials and Methods: A cross-sectional online survey was conducted. The demographical and occupational data were collected using a questionnaire and burnout level was assessed by Maslach Burnout Inventory (MBI).
Results: 748 physicians took the survey. The burnout levels stated by the physicians were found to be significantly higher than before the pandemic [median before pandemic 3 (CDA: 2-4); median 4 (2-5) during pandemic; p <0.001]. Personal Accomplishment (PA), Emotional Exhaustion (EE) and Depersonalization (D) scores of participants directly providing medical services to COVID-19 cases were significantly higher (p <0.05). While EE and D scores were highest in first step workers, PA scores were highest in third step workers. PA scores were lower in man and EE scores were higher in women (p<0.05). Negative correlation was found between the age and the EE [r: (-) 0.087; p< 0.017] and D [r: (-) 0.233; p<0.001] subscale scores.
Conclusion: We concluded that women, younger, first step and frontline workers had higher risks for burnout, so individual, structural, and organizational arrangements should be made by giving priority to these risky groups.
References
- Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. New England journal of medicine 2020; 382 (18): 1708-1720.
- West CP, Dyrbye LN, Shanafelt TD. Physician burnout: contributors, consequences and solutions. Journal of internal medicine. 2018; 283 (6): 516-529.
- Barello S, Palamenghi L, Graffigna G. Burnout and somatic symptoms among frontline healthcare professionals at the peak of the Italian COVID-19 pandemic. Psychiatry Research. 2020; 113129.
- Rossi R, Socci V, Pacitti F, Di Lorenzo G, Di Marco A, Siracusano A, et al. Mental Health Outcomes Among Frontline and Second-Line Health Care Workers During the Coronavirus Disease 2019 (COVID-19) Pandemic in Italy. JAMA Network Open. 2020; 3 (5): e2010185-e2010185.
- Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA network open. 2020; 3 (3): e203976-e203976.
- Maslach C, Jackson S, Leiter M. Burnout inventory manual. Palo Alto, CA: Consulting Psychologists. 1996.
- Capri B. Tukenmislik olceginin Turkce uyarlaması: Gecerlik ve guvenirlik calimasi. Mersin Universitesi Egitim Fakultesi Dergisi. 2006; 2 (1): 62-77.
- Ádám S, Gyorffy Z, Susánszky É. Physician burnout in Hungary: a potential role for work family conflict. Journal of health psychology. 2008; 13 (7): 847-856.
- Aslan SH, Ünal M, Aslan RO. Pratisyen Hekimlerde Tükenme Düzeyleri. Düşünen Adam 1996; 9: 48-52.
- Sünter, A. T., Canbaz, S., Dabak, Ş., Öz, H., & Pekşen, Y. (2006). Pratisyen hekimlerde tükenmişlik, işe bağlı gerginlik ve iş doyumu düzeyleri. Genel Tıp Dergisi, 16 (1), 9-14.
- Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job burnout. Annual review of psychology, 52 (1), 397-422.
- Aslan, D., Kiper, N., Karaağaoğlu, E., Topal, F., Güdük, M., & Cengiz, Ö. S. (2005). Türkiye’de tabip odalarına kayıtlı olan bir grup hekimde tükenmişlik sendromu ve etkileyen faktörler. Ankara: Türk Tabipleri Birliği Yayınları.
- Kaya, A., Çetinkaya, F., Naçar, M., & Baykan, Z. (2014). Aile hekimlerinin tükenmişlik durumları ve ilişkili faktörler. Türkiye Aile Hekimliği Dergisi, 18 (3), 122-133.
- Imo, U. O. (2017). Burnout and psychiatric morbidity among doctors in the UK: a systematic literature review of prevalence and associated factors. BJPsych bulletin, 41 (4), 197-204.
- Qureshi K, Gershon RRM, Sherman MF, Straub T, Gebbie E, McCollum M, et al. Health care workers’ ability and willingness to report to duty during catastrophic disasters. J Urban Heal. 2005; 82: 378–88.
- Shanafelt TD, Gorringe G, Menaker R, Storz KA, Reveez D, Buskirk SJ, et al. Impact of organizational leadership on physician burnout and satisfaction. Mayo Clin Proc. 2015; 90: 432–40.
- Shanafelt TD, Balch CM, Bechamps GJ, Russel T, Lotte D, Satele D, et al. Burnout and career satisfaction among American surgeons. Ann Surg. 2009; 250: 463–71.
- Shanafelt TD, Dyrbye LN, Sinsky C, Hasan O, Satele D, Sloan J et al. Relationship between clerical burden and characteristics of the electronic environment with physician burnout and professional satisfaction. Mayo Clin Proc. 2016; 91: 836–48.
- Özkula, G., & Durukan, E. (2017). Hekimlerde Tükenmişlik Sendromu: Sosyodemografik Özelliklerin Rolü. Dusunen Adam, 30 (2), 136.
- West, C. P., Dyrbye, L. N., & Shanafelt, T. D. (2018). Physician burnout: contributors, consequences and solutions. Journal of internal medicine, 283 (6), 516-529.
- Lung FW, Lu YC, Chang YY, Shu BC. Mental symptoms in different health professionals during the SARS attack: a follow-up study. Psychiatry Q. 2009; 80 (2): 107–16.doi: 10.1007/s11126-009-9095-5. Epub 2009 Feb 27.
- Mak IWC, Chu CM, Pan PC, Yiu MGC, Chan VL. Long-term psychiatric morbidities among SARS survivors. Gen. Hosp. Psychiatry. 2009; 31 (4): 318–26. doi:10.1016/j.genhosppsych. 2009.03.001. Epub 2009 Apr 15.
- Lu YC, Shu BC, Chang YY, Lung FW. The mental health of hospital workers dealing with severe acute respiratory syndrome. Psychother Psychosom. 2006; 75 (6): 370–5.
- Sultana A, Sharma R, Hossain M, Bhattacharya S, Purohit N. Burnout among healthcare providers during COVID-19 pandemic: Challenges and evidence-based interventions. 2020.
COVID-19 pandemisi sırasında hekimlerde tükenmişliği etkileyen faktörler
Year 2021,
Volume: 60 Issue: 2, 136 - 144, 30.06.2021
Osman Hasan Tahsin Kılıç
,
Murat Anıl
Umut Varol
Zeynep Sofuoğlu
,
Istemihan Coban
,
Hakan Gülmez
,
Güven Güvendi
,
Berna Dirim Mete
Abstract
Amaç: COVID-19 salgını, tüm dünyada insanların fiziksel ve zihinsel sağlığı için tehdit oluşturmaya devam etmektedir. Salgınla mücadeleye doğrudan dahil olan sağlık çalışanları, bu kriz sırasında tükenmişliğe ve İkincil travmaya neden olabilecek stres yaşayabilmektedir. Çalışmamızın amacı COVID-19 salgını sırasında hekimler arasındaki tükenmişliği değerlendirmek ve ilişkili faktörleri belirlemektir.
Gereç ve Yöntem: Kesitsel çevrimiçi anket uygulanmıştır. Demografik ve mesleki veriler anket kullanılarak toplanmış ve tükenmişlik düzeyi Maslach Tükenmişlik Envanteri (MBI) ile değerlendirilmiştir.
Bulgular: Ankete 748 hekim katıldı. Hekimlerin belirttiği tükenmişlik düzeyleri pandemi öncesine göre anlamlı düzeyde yüksek bulunmuştur [pandemi öncesi ortanca 3 (CDA: 2-4); pandemi sırasında ortanca 4 (2-5)]. COVID-19 vakalarına doğrudan tıbbi hizmet veren hekimlerin Kişisel Başarı Hissi (PA), Duygusal Tükenmişlik (EE) ve Duyarsızlaşma (D) puanları anlamlı olarak daha yüksek saptandı (p <0.05). EE ve D puanları ilk basamakta çalışan hekimlerde en yüksek iken, PA puanları üçüncü basamakta çalışanlarda en yüksek saptandı. PA puanı erkeklerde daha düşük, EE puanları kadınlarda daha yüksek saptandı (p <0.05). Yaş ile EE ve D alt ölçek puanları arasında negatif korelasyon bulundu. (EE için r: (-) 0.087; p <0.017] ve D için [r: (-) 0.233; p <0.001]).
Sonuçlar: Bu çalışmada kadınların, gençlerin, birinci basamakta ve ön saflarda çalışanların tükenmişlik riskinin daha yüksek olduğu sonucuna ulaşıldı. Çalışmamızda, belirlenen riskli gruplara öncelik verilerek bireysel, yapısal ve örgütsel düzenlemeler yapılması gerektiği vurgulanmaktadır.
References
- Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. New England journal of medicine 2020; 382 (18): 1708-1720.
- West CP, Dyrbye LN, Shanafelt TD. Physician burnout: contributors, consequences and solutions. Journal of internal medicine. 2018; 283 (6): 516-529.
- Barello S, Palamenghi L, Graffigna G. Burnout and somatic symptoms among frontline healthcare professionals at the peak of the Italian COVID-19 pandemic. Psychiatry Research. 2020; 113129.
- Rossi R, Socci V, Pacitti F, Di Lorenzo G, Di Marco A, Siracusano A, et al. Mental Health Outcomes Among Frontline and Second-Line Health Care Workers During the Coronavirus Disease 2019 (COVID-19) Pandemic in Italy. JAMA Network Open. 2020; 3 (5): e2010185-e2010185.
- Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA network open. 2020; 3 (3): e203976-e203976.
- Maslach C, Jackson S, Leiter M. Burnout inventory manual. Palo Alto, CA: Consulting Psychologists. 1996.
- Capri B. Tukenmislik olceginin Turkce uyarlaması: Gecerlik ve guvenirlik calimasi. Mersin Universitesi Egitim Fakultesi Dergisi. 2006; 2 (1): 62-77.
- Ádám S, Gyorffy Z, Susánszky É. Physician burnout in Hungary: a potential role for work family conflict. Journal of health psychology. 2008; 13 (7): 847-856.
- Aslan SH, Ünal M, Aslan RO. Pratisyen Hekimlerde Tükenme Düzeyleri. Düşünen Adam 1996; 9: 48-52.
- Sünter, A. T., Canbaz, S., Dabak, Ş., Öz, H., & Pekşen, Y. (2006). Pratisyen hekimlerde tükenmişlik, işe bağlı gerginlik ve iş doyumu düzeyleri. Genel Tıp Dergisi, 16 (1), 9-14.
- Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job burnout. Annual review of psychology, 52 (1), 397-422.
- Aslan, D., Kiper, N., Karaağaoğlu, E., Topal, F., Güdük, M., & Cengiz, Ö. S. (2005). Türkiye’de tabip odalarına kayıtlı olan bir grup hekimde tükenmişlik sendromu ve etkileyen faktörler. Ankara: Türk Tabipleri Birliği Yayınları.
- Kaya, A., Çetinkaya, F., Naçar, M., & Baykan, Z. (2014). Aile hekimlerinin tükenmişlik durumları ve ilişkili faktörler. Türkiye Aile Hekimliği Dergisi, 18 (3), 122-133.
- Imo, U. O. (2017). Burnout and psychiatric morbidity among doctors in the UK: a systematic literature review of prevalence and associated factors. BJPsych bulletin, 41 (4), 197-204.
- Qureshi K, Gershon RRM, Sherman MF, Straub T, Gebbie E, McCollum M, et al. Health care workers’ ability and willingness to report to duty during catastrophic disasters. J Urban Heal. 2005; 82: 378–88.
- Shanafelt TD, Gorringe G, Menaker R, Storz KA, Reveez D, Buskirk SJ, et al. Impact of organizational leadership on physician burnout and satisfaction. Mayo Clin Proc. 2015; 90: 432–40.
- Shanafelt TD, Balch CM, Bechamps GJ, Russel T, Lotte D, Satele D, et al. Burnout and career satisfaction among American surgeons. Ann Surg. 2009; 250: 463–71.
- Shanafelt TD, Dyrbye LN, Sinsky C, Hasan O, Satele D, Sloan J et al. Relationship between clerical burden and characteristics of the electronic environment with physician burnout and professional satisfaction. Mayo Clin Proc. 2016; 91: 836–48.
- Özkula, G., & Durukan, E. (2017). Hekimlerde Tükenmişlik Sendromu: Sosyodemografik Özelliklerin Rolü. Dusunen Adam, 30 (2), 136.
- West, C. P., Dyrbye, L. N., & Shanafelt, T. D. (2018). Physician burnout: contributors, consequences and solutions. Journal of internal medicine, 283 (6), 516-529.
- Lung FW, Lu YC, Chang YY, Shu BC. Mental symptoms in different health professionals during the SARS attack: a follow-up study. Psychiatry Q. 2009; 80 (2): 107–16.doi: 10.1007/s11126-009-9095-5. Epub 2009 Feb 27.
- Mak IWC, Chu CM, Pan PC, Yiu MGC, Chan VL. Long-term psychiatric morbidities among SARS survivors. Gen. Hosp. Psychiatry. 2009; 31 (4): 318–26. doi:10.1016/j.genhosppsych. 2009.03.001. Epub 2009 Apr 15.
- Lu YC, Shu BC, Chang YY, Lung FW. The mental health of hospital workers dealing with severe acute respiratory syndrome. Psychother Psychosom. 2006; 75 (6): 370–5.
- Sultana A, Sharma R, Hossain M, Bhattacharya S, Purohit N. Burnout among healthcare providers during COVID-19 pandemic: Challenges and evidence-based interventions. 2020.